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Successful pregnancy in a CKD patient on a low-protein, supplemented diet: an opportunity to reflect on CKD and pregnancy in Mexico, an emerging country
- Source :
- Journal of Nephrology. 30:877-882
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Pregnancy is probably the most important challenge in young women with chronic kidney disease (CKD). The challenge is greater in developing countries, in which access to dialysis is uneven, and prenatal care for CKD patients is not uniformly available. This case report summarizes some of the challenges faced by pregnant CKD women in a developing country. A 35-year-old woman, affected by an undiagnosed kidney disease, experienced preeclampsia at 24 years of age, and started dialysis in emergency at age 31 in the context of severe preeclampsia in her second pregnancy. Following slow recovery of kidney function, after 18 months of dialysis she started a moderately restricted, supplemented, low-protein diet, which allowed her to discontinue dialysis. A few months after dialysis discontinuation, she started a new pregnancy in the presence of severely reduced kidney function (serum creatinine 4.6 mg/dl at the last pre-pregnancy control). Interestingly, she discontinued nephrology and nutritional follow-up, mainly because she was worried that she would be discouraged from continuing the pregnancy, but also because she continued to feel well. She self-managed her diet in pregnancy and delivered a healthy baby, with normal intrauterine growth, at term; while the last laboratory data confirmed the presence of severe kidney function impairment, she is still dialysis-free at the time of the present report. Her story, with its happy ending, underlines the importance of dedicated programs for CKD pregnancies in developing countries and confirms the safety of moderately protein-restricted diets in pregnancy.
- Subjects :
- Adult
Nephrology
medicine.medical_specialty
Pediatrics
Low protein
medicine.medical_treatment
030232 urology & nephrology
Emerging country
Context (language use)
Prenatal care
KEYWORDS: CKD
Compliance
Dialysis discontinuation
Empowerment
Low-protein diets
Pregnancy
Supplemented diets
030204 cardiovascular system & hematology
Preeclampsia
03 medical and health sciences
0302 clinical medicine
Renal Dialysis
Internal medicine
Diet, Protein-Restricted
Humans
Medicine
Renal Insufficiency, Chronic
Intensive care medicine
Dialysis
business.industry
Infant, Newborn
medicine.disease
Pregnancy Complications
Dietary Supplements
Female
business
Kidney disease
Subjects
Details
- ISSN :
- 17246059 and 11218428
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....5aa31c6629474d7dd4cb88a9a9526590